Amaurosis fugax as the presenting manifestation of dural arteriovenous malformation.

A 46-year-old woman under investigation for three episodes of amaurosis fugax in the left eye proved to have a left anterior-middle fossa dural arteriovenous malformation with pial venous drainage. The malformation received its main supply from the left middle meningeal artery, but its anterior part was fed by the recurrent meningeal branch of the left ophthalmic artery. Transient episodic lowering of retinal arterial pressure due to shunting of blood from the ophthalmic artery to the malformation is the most likely explanation for the occurrence of amaurosis fugax, indicating that this symptom occurs in some patients on a hemodynamic basis.

A secondary prevention, randomized trial of suloctidil in patients with a recent history of thromboembolic stroke.

Four hundred and thirty-eight patients who had suffered a thromboembolic stroke not less than two weeks or more than four months previously, were entered into a placebo-controlled randomized clinical trial to determine whether suloctidil (200 mg t.i.d.

Prognosis in middle cerebral artery occlusion.

The natural history of MCA occlusion has become increasingly important since the surgical option of EC/IC bypass surgery has been available. The clinical course of 24 patients with angiographically-demonstrated occlusion of the MCA artery was reviewed. Eight patients presented with a major disabling stroke and five of these died during the acute phase of this ischemic event.

[Cardiac and arterial causes of transient monocular blindness].

It has been accepted that transient monocular blindness (TMB) is highly suggestive of an ipsilateral carotid artery lesion in patients with arterial risk factors. We confirmed this in 55 patients, who had an internal carotid artery severe stenosis, occlusion or ulceration on angiography in more than 50 per cent of the cases. However, 12-lead-ECG, 2 D--echocardiography and Holter monitoring also showed a potential cardiac source of emboli in 22 per cent of the patients.

Mitral valve prolapse and cerebral ischemic events in young patients.

We evaluated 32 young patients with mitral valve prolapse (MVP) as the only recognized cause of cerebral ischemia. The mean follow-up from the time of the first ischemic event was 8 years. At the time of the follow-up evaluation, 24 patients (75%) had a normal cardiac examination, and 4 had midsystolic clicks; only 1 had the characteristic click-murmur.

Discounting surgical benefits. Enucleation versus resection of the prostate.

This manuscript introduces and demonstrates a modification of the popular cost-effectiveness methodology. Because arbitrarily selected discount rates for future health effects can radically change the cost-effect ratio, the determinants of the ratio--differences in the present values of effects and costs-are examined for a wide range of discount rates. Treatment selection then follows directly from explicit judgments about expected patient longevity and appropriate combinations of cost and effect discount rates.

Occurrence and mechanisms of occlusion of the anterior cerebral artery.

Occlusion of the anterior cerebral artery is a rare condition. A review of CT scans from 413 patients with ischemic infarction confirmed this low relative incidence: only 3% of CT scans evidencing infarction involved the territory of the anterior cerebral artery. Four major mechanisms of anterior cerebral artery occlusion have been identified in this series: Emboli in unusual hemodynamic circumstances such as patients presumed to have increased flow through the anterior communicating artery because of unilateral internal carotid artery occlusion.

Internal carotid occlusion: a prospective study.

Forty-seven patients with ICA occlusion and who presented either without any or only a mild neurological deficit were prospectively followed for an average of 34.4 months. During this period of time, 11 patients (23.

CT visualization of intracranial arterial thromboembolism.

Eight cases of presumed acute occlusion of intracranial arteries, 7 middle cerebral and 1 posterior cerebral, demonstrated the occluded artery as an abnormal high density structure on non-enhanced computed tomography. Three cases underwent subsequent angiography which confirmed the diagnosis. CT scanning is therefore able to visualize acute thromboembolism in the intracranial arteries.

Heart in ischemic stroke--a changing emphasis.

The author discusses how the application of advances in cardiac investigation has improved the understanding and treatment of the heart in ischemic stroke.

Delayed CT metrizamide enhancement of syringomyelia secondary to tumor.

Six cases of syringomyelia associated with intramedullary tumor were examined by metrizamide myelography and delayed computed tomography. All cases showed opacification of syringomyelic cavities 7-24 hr after myelography. This finding suggests that metrizamide can pass through the cord substance from the subarachnoid space into a syrinx cavity in noncommunicating types of syringomyelia.

Intracranial internal carotid artery stenosis.

The advent of EC/IC Bypass surgery has focused attention on selected patients who might benefit from this innovative procedure. There is a poverty of natural history data pertaining to all such lesions. Two centres (Memphis, Tennessee and London, Ontario) pooled their resources to carry out a retrospective review of 58 patients with angiographically-proven intracranial internal carotid artery stenosis.

A mortality study of lead workers 1925-76.

The principal causes of mortality of 754 individuals from a population of 1898 pensioners from four lead acid battery factories during the period 1 January 1925 to 31 December 1976 were studied. In addition the causes of 553 deaths occurring before retirement was also studied. All subjects were placed into one of three groups according to their history of lead exposure.

Value and limitations of clinical electrophysiologic study in assessment of patients with unexplained syncope.

We assessed the value of clinical electrophysiologic study using intracardiac recording and programed electrical stimulation in 34 patients who had unexplained syncope and/or presyncope. All patients had normal electrocardiograms, and no abnormality was detected by clinical examination, ambulatory electrocardiographic recording, or treadmill testing. The electrophysiologic results were diagnostic in four patients (11.

Manometric and Electrode-Probe Determination of CO in Fish Flesh.

A rapid electrometric method for determining endogenous and added CO in fish products was studied using an Orion CO probe and Orion ionalyzer model #801. Analytical results were compared to those using the standard Warburg manometric technique. Comparisons showed a ± 20.

Progressive supranuclear palsy: the relationship between ocular motor dysfunction and psychological test performance.

The performance of patients with progressive supranuclear palsy on visual search and scanning tasks was related to the pattern of ocular deficits observed in these patients during horizontal refixation. Comparisons were made to age-matched normals and patients with Parkinson disease or cerebellar damage. The poor performance of the progressive supranuclear palsy group on visual search and scanning could not be attributed to the restricted range of vertical gaze or the large number of hypometric saccades during horizontal refixation.